Evaluation of Periodontal Status among Men Undergoing Infertility Treatment

Effects of periodontal disease on the reproductive performance and offspring of Wistar rats

BACKGROUND

Periodontitis can induce systemic inflammation, and it may affect the testicles and male reproductive performance. This study investigated the effects of periodontitis on the testicles, reproductive performance, and offspring development in male rats.

METHODS

Male Wistar rats were induced with periodontitis by ligating their first molars. After 14 days of inducing periodontal lesions, the animals were observed for an additional 54 days, corresponding to a complete cycle of spermatogenesis. Rats from the periodontitis group (GP, n = 12) and the control group (GC, n = 12) were paired with healthy females (n = 48) for 10 days, equivalent to 2 estrous cycles. Post-mating, the males underwent microtomographic, histological, and reproductive parameter assessments.

RESULTS

Microtomographic analysis revealed higher porosity around the first molar in GP (26 ± 6%) and greater distance between the amelocemental junction and the alveolar bone (1.37 [1.12-1.90] mm), indicative of bone resorption. GP also exhibited significant decreases in final body weight, reduced Sertoli and Leydig cell counts, and lowered testosterone levels compared to GC. Significant morphological alterations in sperm tails were observed in GP compared to GC.

CONCLUSIONS

Periodontitis adversely affected reproductive performance, evoking, and offspring development in male rats. These findings highlight the systemic impacts of periodontal disease on male reproductive health in an animal model.

PLAIN LANGUAGE SUMMARY

Our study investigated how periodontitis can affect male reproductive health in rats and offspring development. We induced periodontitis in male rats and, after a full cycle of sperm production, these rats were mated with healthy females. We observed that the rats with periodontitis had worse reproductive performance compared to the control group without periodontitis. Additionally, the offspring of the rats with periodontitis showed signs of compromised intrauterine development and a higher incidence of congenital malformations. These results highlight that the inflammation caused by periodontitis can have adverse effects beyond the mouth, significantly impacting male reproductive health and offspring development. These findings suggest the need for further research into the clinical implications of periodontitis on reproductive health.

Is there an association between periodontal disease and infertility? A systematic review

BACKGROUND

Today, idiopathic infertility is becoming more frequent, affecting more than 186 million people in the world. The presence of comorbidities makes patient management complex, requiring individualized infertility treatment. Periodontal diseases could contribute negatively to the management of infertility, increasing inflammation, oxidative stress and insulin resistance, and contributing negatively to the development and progression of comorbidities associated with these two entities. The aim of this systematic review is to explore whether there is an association between periodontal diseases and male and female infertility and deepen into the possible mechanisms underlying this association.

MATERIAL AND METHODS

The studies analyzed in this research included a total of 4871 patients (732 men and 4139 women), were original studies with high quality, mostly with a control group. Authors who have investigated idiopathic infertility suggest that infertility is associated with diseases that present low-grade chronic inflammation, oxidative stress and insulin resistance (such as obesity, type 2 diabetes and polycystic ovary syndrome), which are in turn related to periodontal diseases.

RESULTS

A higher prevalence of periodontal disease was found in patients with infertility compared with controls. Periodontal diseases could initially be mediated by a local and systemic proinflammatory environment, which favors a pro-oxidant state, leading to oxidative stress and, finally, irreversible destruction of the periodontal tissue. Insulin resistance, oxidative stress and inflammation are present in the pathologies associated with an increase in the prevalence and severity of periodontal diseases (such as obesity, type 2 diabetes and polycystic ovary syndrome). Therefore, IR, low-grade chronic inflammation and the oxidative stress could be the pathophysiological mechanisms linking idiopathic infertility and periodontal diseases.

CONCLUSIONS

Studies suggest an association between infertility and periodontitis. Future researches are necessary to find causality factors. Studying the patient in a global and multidisciplinary way could help in the management and treatment of idiopathic infertility.

Can periodontal disease affect conception? A literature review

Today periodontal health is considered as an integral part of systemic health itself and no longer as a single factor. The literature recognizes that the presence of periodontal disease can represent a risk factor for numerous systemic conditions such as heart disease and diabetes. In recent years, we have witnessed a progressive interest regarding the influence exerted by this condition on reproduction, as well as the possible repercussions on conception possibilities. Upon analyzing a limited number of studies available for the correlation between periodontal disease and female infertility, it could be inferred that this condition can be equated to the presence of a real outbreak of infection and therefore exert its influence, not only through bacterial translocation in the bloodstream, causing the systemic dissemination of pathogens, but also through the production of cytokines and immunoglobulins by inflammatory mediators. This situation limits bacterial growth, but it could cause damage to the fetus, to the reproductive system, and could hinder conception attempts. Although further research is needed to better clarify the mechanism underlying the possible correlation between periodontal disease and female infertility, the present article aims to review all the available literature on this topic.

Periodontitis, erectile dysfunction, reproductive hormones, and semen quality: A systematic review

BACKGROUND

There is increasing evidence that periodontitis may affect male sexual health (MSH) (erectile function, production of sex hormones, and semen quality). However, a limited number of clinical studies demonstrate the association between MSH and periodontitis.

OBJECTIVES

The aim of this study was to explore the relationship between periodontitis and MSF.

MATERIALS AND METHODS

A comprehensive systematic review of the published literature in MEDLINE, PubMed, Scopus, Cochrane, EMBASE, and Web of Science databases from the earliest available online indexing year until October 2020 was performed, in accordance with the PRISMA guidelines. Keywords related to periodontitis were combined with words describing MSH.

RESULT

A total of 19 studies were included and discussed in the systematic review. The number of study participants ranged from 53 to 197,136 individuals, aged between 18 and 95 years (mean age, 41.2 years). Six studies did not report the age of the participants. Out of nine studies, eight found a significant association between erectile dysfunction (ED) and periodontitis. Only three studies evaluated the association between sex hormone levels and periodontitis, and two of these studies showed that patients with periodontitis are expected to exhibit higher levels of testosterone. Finally, out of five studies, two demonstrated a significant association between semen quality and periodontitis.

DISCUSSION

The findings in this review were limited by the quality and the few available studies. Results from the observational studies might have been affected by recall bias and confounded by cofactors.

CONCLUSION

The results of this systematic review revealed a significant association between periodontitis and ED, although the responsible mechanisms remain unclear. The potential associations between sex hormone levels, semen quality, and periodontitis are yet to be demonstrated. In order to improve patient management, dentists and physicians need to be aware of the association between male sexual health problems and periodontitis.